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目的 探讨神经病学、肿瘤学、脊柱生物力学、全身系统情况(NOMS)治疗决策框架在指导脊柱转移瘤治疗决策中的意义和价值.方法 对59例脊柱转移瘤患者应用NOMS治疗决策框架进行术前评估并制定治疗方案.结果 49例获得随访,随访5 ～ 30个月,平均16个月,1例术后20 d死亡,未发现内固定松动及术后再骨折者.脊髓及神经根损害患者术后均得到不同程度缓解,肿瘤患者生存质量评分平均提高18.0分.结论 NOMS治疗决策框架是从NOMS方面综合评估脊柱转移瘤患者情况并指导临床医生制定治疗方案,合理选择手术方式、放射治疗等,可以取得较好的临床效果.“,”Objective To evaluate the clinical value of the neurologic,oncologic,mechanical and systemic (NOMS) treatment decision-making framework in making the treatment decision of the patients with spinal metastatic tumor.Methods The preoperative evaluation and treatment plans were completed in 59 patients with spinal metastatic tumor according to the NOMS treatment decision-making framework.Results Forty-nine patients were followed up for 5-30 months (mean 16 months).One case died on the 20th day postoperatively.There was no internal fixation loosening and postoperative fracture again.The patients with spinal cord and nerve root injury acquired different degree remission.The quality of life (QOL) score increased mean 18.0 scores.Conclusion Because of the NOMS treatment decision-making framework can evaluate the condition of patients with spinal metastatic tumor from NOMS,and can guide the clinical doctor to make treatment plans,select the appropriate and correct therapeutic methods,and obtain a better clinical effect.